Table 1

Quality Indicators Used to Measure Adherence to Standards of Breast Cancer Care

Type of Quality Indicator
n
Extent of scientific development as a quality measure*

Diagnosis
Appropriate use of imaging, sampling (fine-needle or biopsy) within given time-frame
8
IV
Adequacy of fine-needle biopsy samples
1
IV
Receipt of frozen section of primary operable BC
1
IV
Quality of surgical technique, sampling nodes
2
IV
Quality of hormone receptor assay
1
IV
Quality of life and patient satisfaction relating to diagnosis
2
Iac
Appropriate referral to surgeon
2
IV
Appropriate (timely) attendance at assessment centre, specialist appointment, surgery, receipt of information by patient
5
IV
Efficient diagnosis (few visits to hospital)
1
IV
Appropriate evaluation vis a vis guidelines, or at first visit
2
IV
Appropriate specialist knowledge of surgeons
1
IV
Treatment
Appropriate surgical choices – breast conserving, mastectomy, lymph node dissection
7
IV
Timely admission for therapeutic surgery
1
IV
< 3 operations for breast-conserving surgery
1
IV
Evidence of discussion of surgical options
1
IV
Appropriate use, timeliness of initial radiotherapy
6
IV
Quality of radiotherapy planning, fractionation, radiation field distribution
7
IV
Regional recurrence
1
IV
Appropriate use of radiotherapy for regional recurrence, palliation
1
IV
Appropriate use (or not) of adjuvant systemic therapy
23
IV
Chemotherapy quality of administration – dosages and availability of procedure manual
2
IV
Quality of life, satisfaction with treatment
6
Ia, Iac
Participation in decision-making, receipt of sufficient information re. treatment
2
IV
Qualifications of doctors
2
IV
Appropriate referrals to specialists
2
IV
Appropriate treatment choices, sequences
5
IV
Followup
Appropriate followup mammography, use of guidelines
2
IV
Recurrence within 5 years
2
IV
Appropriate use of prophylactic radiotherapy in women with high risk of flap recurrence
1
IV
Reporting/Documentation
Pathology reporting/documentation
42
IV
Imaging reporting/documentation – size of mammographic abnormality
1
IV
Chemotherapy reporting/documentation
2
IV

n = number of different quality indicators regarding this type; *extent of scientific development of quality indicator: Level Ia = pre-study data indicating consistently sound psychometric properties; Iac = pre- and on-study data indicating consistently sound psychometric properties; IV = no pre- or on-study psychometric data

Schachter et al. BMC Cancer 2006 6:291   doi:10.1186/1471-2407-6-291